“Selective peripheral neurotomies” (SPNs) are indicated for the treatment of refractory focal and multifocal spasticity of lower limbs in adults.
To evaluate the surgical results of selective ...peripheral neurotomies in 20 adult patients who had refractory focal & multifocal spasticity of the lower limbs, follow up period of one year.
Prospective study included 20 adult patients who had refractory spasticity of the lower limbs. Preoperative evaluation for muscle tone using Modified Ashworth Score (MAS), muscle power using Medical Research Council Scale (MRCS), functional assessment using Oswestry Functional Scale (OFS) and Range Of Motion (ROM) using manual goniometry were done for all patients. All cases underwent surgery in the form of SPN of tibial, obturator, sciatic and/or femoral nerves. Follow up of the patients was done at 10th day, 3, 6months and one year postoperatively.
The mean age of patients was 31.35±12.42years. There were statistically significant improvement of muscle tone, muscle power, functional assessment and range of motion between preoperative and one year postoperative values. Improvement of the muscle tone was from a preoperative Mean±SD of 3.60±0.68 on MAS to a postoperative 2.30±0.86 at one year, improvement of muscle power on MRCS was from preoperative Mean±SD 3.75±1.08 to postoperative 4.08±0.69 at one year, There was a functional improvement from a preoperative Mean±SD of 3.0±0.73 on OFS to 3.60±0.60 at one year postoperatively. Also, there was a significant improvement between preoperative ROM Mean±SD 61.25±15.29 and one year postoperatively 72.25±12.19.
Selective peripheral neurotomies could effectively improve muscle tone, muscle power, functional performance & range of motion in patients with refractory focal and multifocal spasticity in the lower limbs.
Currently, lung cancer has rapidly become the malignancy with the highest morbility and motality in China, with an overall 5-year survival rate of only 10-15%. Early diagnosis and surgical excision ...is critically important to increase the survival rate of patients with lung cancer and improve their prognosis. However, patients with early lung cancer often have no specific symptom or sign, manifest radiologically only as solitary pulmonary nodules (SPNs). Here we describe a patient presenting with SPN, which was confirmed to be lung adenocarcinoma with pleural metastasis 23 days later.
The solitary pulmonary nodule (SPN) is a common and challenging clinical problem, especially solid SPN. The object of this study was to explore the predictive factors of SPN appearing as pure solid ...with malignance and to establish a clinical prediction model of solid SPNs.
We had a retrospective review of 317 solid SPNs (group A) having a final diagnosis in the department of thoracic surgery, Shanghai Chest Hospital from January 2015 to December 2015, and analyzed their clinical data and computed tomography (CT) images, including age, gender, smoking history, family history of cancer, previous cancer history, diameter of nodule, nodule location (upper lobe or non-upper lobe, left or right), clear border, smooth margin, lobulation, spiculation, vascular convergence, pleural retraction sign, air bronchogram sign, vocule sign, cavity and calcification. By using univariate and multivariate analysis, we found the independent predictors of malignancy of solid SPNs and subsequently established a clinical prediction
This paper investigates the problem of robust passivity and passification for a class of singularly perturbed nonlinear systems (SPNS) with time-varying delays and polytopic uncertainties via neural ...networks. By constructing a proper functional and the linear matrix inequalities (LMIs) technique, some novel sufficient conditions are derived to make SPNS passive. The allowable perturbation bound
ξ
∗
can be determined via certain algebra inequalities, and the proposed controller based on neural network will make SPNS with polytopic uncertainties passive for all
ξ
∈(0,
ξ
∗
). Finally, a numerical example is given to illustrate the theoretical results.
An early differentiation of malignant from benign solitary pulmonary nodules (SPNs) is essential for management and prognosis of lung cancer.
Here we investigated whether measurement of circulating ...sex hormones could be useful for an early detection of malignancy among patients with SPNs.
We recruited 47 patients with malignant SPNs 45 patients with benign SPNs, and 32 healthy persons. Testosterone, estradiol, and progesterone were measured. Carcinoembryonic antigen (CEA) as well as TNF-α, IL-1 and IL-6 were also measured.
We found that sex hormones were decreased significantly in patients with malignant SPNs, as compared to patients with benign SPNs and healthy controls (P<0.05). Sex hormones levels showed a trend to decline in patients with benign SPNs as compared to normal controls, but the difference was not statistically significant (P>0.05). CEA levels were only abnormally elevated in eight patients with lung adenocarcinoma. The inflammatory cytokines were remarkably higher in both patients than in normal controls. However, there was no statistical difference in these cytokines among patients.
The reduced sex hormones levels seemed to be uniquely associated with lung cancer. Therefore, measurement of sex hormones may have clinical potential in the diagnosis of malignancy in patients with SPNs.
Prevention with Positives (PwP) is a component of the US HIV prevention strategy that targets HIV-infected persons who are aware of their seropositive status. This paper examines the use of ...prevention messages by clinical providers during the PwP intervention period of the US Health Resources and Services Administration's Special Projects of National Significance program. Quantitative approaches were used to learn which prevention topics were most discussed and qualitative interviews were also utilized to better understand the clinician perspective in providing prevention counseling. At 12-month follow-up, there was a significant increase in the percent of patients receiving all PwP counseling messages (p<0.01). Providers reported discussing safer sex with 91% of patients when sexually transmitted infection (STI) screening was conducted during a visit, an increase from baseline (83.5%). The percent of providers reporting they regularly explained the risk of superinfection to their clients also increased from 75% at baseline to 90% at 12-month follow up (p<0.001). Qualitative data suggest that providers prioritize individual care over public health approaches to PwP in counseling. Discussing superinfection offered providers a way to discuss HIV prevention from a non-judgmental clinical perspective while focusing on a patient-centered philosophy of care. However, the threat of superinfection may not be the best counseling option. Examples such as STI screening, giving messages to reduce the number of sexual partners and adherence to medication, are more evidence-based approaches to changing HIV transmission risk behavior and may be more important in PwP. Findings suggest that in order for HIV care providers to incorporate HIV prevention discussions into their practice, acceptable approaches to speaking about risk behavior and prevention of HIV transmission must be developed.
Background:
Adherence to highly active antiretroviral therapy (HAART) is crucial for success. Therefore, having validated tools to help assess adherence is necessary. The Health Resources and ...Services Administration assessed adherence as a Special Project of National Significance (SPNS). As a result of their study, a 3-question survey was developed as a simple tool to assess adherence in patients with HIV/AIDS.
Objective:
To validate the SPNS adherence survey as an accurate and effective way to assess adherence and to determine whether any other independent variables correlate with a significant reduction in viral load.
Methods:
The study was a retrospective chart review of 300 patients actively enrolled in an HIV/AIDS clinic from January 2007 to September 2007. Patients were eligible for the study if they had been on HAART for at least 6 months, were 2:18 years old, and had completed at least 2 surveys.
Results:
A total of 74 patients met the criteria; the majority were male (75.3%) and African American (91.9%). Twenty-six (35.1%) patients had scores ≤10, indicating poorer adherence, and 48 (64.9%) patients had scores ≤11. The mean number of antiviral plus other medications was 4.4. Dosing of HAART drugs was once (5 nonadherent, 23 adherent pts.) and twice (21,25 pts., respectively) daily, and mean number of different antiretroviral tablets/capsules being taken was 1.7 and 1.5, respectively, The nonadherent patients’ average viral load was 15,202.3 copies/mL, while the adherent patients’ average viral load was 163.8 copies/mL (p = 0.001) The SPNS score was significantly associated with HIV-RNA viral load (-0.482, p < 0.001), There also was a significant association between a higher HIV-RNA viral load and the total number of medications a patient was taking, as well as the number of different antiretroviral tablets/capsules being taken (0.299, p = 0.01; 0.249, p = 0.03). There was no significant difference in HIV-RNA viral load when comparing age, sex, race, income, and frequency of HIV drug dosing.
Conclusions:
The SPNS survey is a valid and simple tool in measuring adherence that can aid health-care professionals in assessing adherence to HAART.
Huge amounts of data are ceaselessly being generated by a variety of devices, and the processing efforts for their collection and analysis grows exponentially as well. Storing them in one place and ...getting exact answers is almost impractical. Furthermore, computing aggregation and statistics that most exploratory data analysis would require imposes a heavy burden on networking and computing infrastructures. By adopting the edge/fog computing paradigm that has recently been developing can reduce such overheads by offloading jobs from central clouds to edge devices. We try to go one step further in this direction by approximating aggregate values and statistics for data analysis using tractable probabilistic models and optimizing network performance. This paper evaluates our preliminary result of our on-going project that was gained by fast-prototyping using Sum-Product Networks.
Intrapulmonary schwannoma is uncommon and preoperative radiological diagnosis is rare. Described is a schwannoma that developed as a pulmonary hilar nodule in a 38-year-old woman. The nodule showed ...strong
18F-fluorodeoxyglucose uptake with a maximum standard uptake value of 5.98 on positron emission tomography and had a high apparent diffusion coefficient (2.5×10
3 mm
2/s) on diffusion-weighted magnetic resonance imaging. Combination of these functional imaging techniques warrants further evaluation in radiological diagnosis of intrapulmonary schwannoma.
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